Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 4003 | NC |
NPI | 1033263637 |
---|---|
Provider Name | Ms. Susan P Bessey |
First Address | Charlotte, NC 28210-7297 |
Second Address | Charlotte, NC 28210-7297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004526411 | AETNA (01) | NC |
0796N | BLUE CROSS BLUE SHIELD (01) | NC |
721041G | (05) | NC |
D3557 | MEDCOST (01) | NC |